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The letters OCD have become a punch line to describe people who make lists or wash their hands a lot. But for some with obsessive compulsive disorder the intrusive thoughts and rituals are disabling. Drugs and behavioral therapies don't always work, so doctors have been trying a new treatment for OCD, deep brain stimulation.

NPR's Jon Hamilton has the story.

JON HAMILTON: Deep brain stimulation is best known as a way to reduce the tremors of Parkinson's disease. A surgeon places wires deep in the brain, they carry electrical impulses from an implanted device a bit like a pacemaker. And a couple of years ago, the FDA approved this treatment for adults with really bad OCD. People like, Mike - he asked me not to use his real name.

Mike is in his late 40s. He says a lot of his compulsions involve cars.

MIKE: Check outside of the door. Check inside the door - check the brakes. Check under the tires.

HAMILTON: And Mike says once he's on the road, every bump can make him wonder if he's just hit something. He says one night his OCD actually got him stuck in a quiet neighborhood.

MIKE: I was driving around for 30 minutes to 45 minutes. I'd go back where I thought I hit something, go check it. And I'd have to do that until it felt just right. And then sometimes when I was rolling around to go back and check again, I would roll over something else. So now I have two things to check.

HAMILTON: The police stopped him twice that night to ask if he was casing the area.

For nearly three decades, Mike tried the usual treatments, but he was still constantly checking faucets so the house wouldn't flood, and light switches, so there wouldn't be a fire. He couldn't hold a job. He was living with his parents.

MIKE: A couple of years ago, I was like, just kind of alone, no friends and just wracked with this stuff day in and day out. And, you know, it was just miserable.

HAMILTON: So, Mike began considering extreme measures. He knew that removing a small part of his brain might reduce symptoms. But Mike's doctor, Ben Greenberg at Brown Medical School, suggested another option. He offered Mike a chance to take part in a study of deep brain stimulation, something that's been tried on only about 50 OCD patients in the U.S.

Greenberg says stimulation has the advantage of being reversible.

Dr. BEN GREENBERG: But it does involve, you know, holes in the skull and indefinitely having devices in you and being tied to a center that is expert and can program these devices.

HAMILTON: Stimulation helps about half the people who get it. Greenberg says it appears to reduce people's symptoms by altering brain circuits involved in mood and behavior.

GREENBERG: What they get is a lot more hours in their day and a lot more ability to function, so the hours are not consumed by these intrusive obsessions and these irresistible compulsions.

HAMILTON: Jeff Szymanski, executive director of the International OCD Foundation, says deep brain stimulation is a good option for people who've run out of other options.

Dr. JEFF SZYMANSKI: You're several years into someone feeling not only very debilitated, but very demoralized. And very desperate in terms of, you know, maybe they aren't able to get out of their house. They're in some cases not able to really take care of themselves.

HAMILTON: For Mike, deep brain stimulation changed everything. Because he was part of a study, he spent three months not knowing whether his device was on or off. And he wasn't feeling any better. Then he made a fateful visit to Dr. Greenberg.

MIKE: He turned it on, oh, probably a little less than two months ago, and I could feel immediately a big difference. I knew at that point that it wasn't on the first three months.

(SOUNDBITE OF LAUGHTER)

HAMILTON: Mike says his OCD symptoms got less intrusive, including his need to constantly check things while driving.

MIKE: It was really like my mind was free of this stuff that had been in there for years, and it was easier for my brain to turn it off a little bit.

HAMILTON: Did you drive a car to the studio today?

MIKE: Yes. Yeah. And I...

HAMILTON: And did you check?

MIKE: Just a little bit.

HAMILTON: Mike says behavioral therapy is working for him now. He's optimistic about getting a good job and living on his own. And he's feeling confident enough to fly to the West Coast this week. Mike will be one about 1,100 people attending the International OCD Foundation conference, which starts Friday in San Diego.

Jon Hamilton, NPR News.

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